川崎病急性期血脂与年龄、冠状动脉病变及严重程度的关系
收稿日期: 2020-12-25
网络出版日期: 2023-06-12
基金资助
长沙市科技计划项目(kq1801091)
Relationship between blood lipids and age, coronary artery disease and its severity in the acute stage of Kawasaki disease
Received date: 2020-12-25
Online published: 2023-06-12
目的 探讨川崎病患儿急性期血脂变化与年龄、冠状动脉病变及严重程度的关系。方法 选取2018年1月至2020年12月收治的241例急性期川崎病患儿作为研究对象(川崎病组),另选本院体检的30例健康儿童作为对照组,比较两组间血脂 [血清总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C)] 水平差异,比较川崎病患儿不同年龄段、有无冠脉病变(CAL)以及不同严重程度CAL组间血脂水平差异。结果 川崎病组241例中男135例、女106例;中位年龄2.17(1.04~4.00)岁,<1岁40例,1~3岁120例,>3岁81例;CAL组94例、NCAL组147例;CAL组Ⅱ级68例、Ⅲ级17例、Ⅳ级9例。对照组30例中男14例、女16例,中位年龄3.00(2.00~5.00)岁。川崎病患儿急性期TG与LDL-C较对照组明显升高,而TC及HDL-C则较对照组明显降低,差异有统计学意义(P<0.05)。不同年龄组间TG差异有统计学意义(P<0.05),随年龄增长呈下降趋势。CAL组TG比NCAL组明显增高,差异有统计学意义(P<0.05)。不同严重程度CAL组间TG差异有统计学意义(P<0.05)。结论 川崎病急性期TC和HDL-C降低,TG和LDL-C升高;TG水平与年龄、CAL及其严重程度相关。
何方园 , 何学华 , 袁勇华 , 朱柳蓉 , 吴意 , 夏晓辉 . 川崎病急性期血脂与年龄、冠状动脉病变及严重程度的关系[J]. 临床儿科杂志, 2023 , 41(6) : 455 -458 . DOI: 10.12372/jcp.2023.22e1030
Objective To investigate the relationship between the changes of blood lipid and age, coronary artery disease and its severity in children with Kawasaki disease (KD). Methods A total of 241 children with acute KD admitted from January 2018 to December 2020 were selected as the study subjects (KD group), and 30 healthy children who underwent physical examination in our hospital were selected as the control group. The levels of serum total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL-C) and high density lipoprotein (HDL-C) were compared between the two groups. The differences in blood lipid levels among KD children of different ages, with or without coronary artery lesions (CAL) and with different severity of CAL were compared. Results There were 241 patients (135 boys and 106 girls) in KD group, and the median age was 2.17 (1.04-4.00) years. Forty children were <1 year old, 120 were 1-3 years old, and 81 were >3 years old. There were 94 children in the CAL group and 147 in the non-CAL group. In the CAL group, 68 children were grade Ⅱ, 17 were grade Ⅲ and 9 were grade Ⅳ. The control group included 30 patients (14 boys and 16 girls) and the median age was 3.00 (2.00-5.00) years. The TG and LDL-C levels of KD children in the acute stage were significantly higher than those in the control group, while the levels of TC and HDL-C were significantly lower than those in the control group, and there were statistically significant differences (P<0.05). There were statistically significant differences in TG among different age groups (P<0.05), and TG showed a decreasing trend with the increase of age. TG in the CAL group was significantly higher than that in the non-CAL group, and the difference was statistically significant (P<0.05). There were statistically significant differences in TG among CAL groups with different severity (P<0.05). Conclusions In the acute stage of KD, the levels of TC and HDL-C were decreased, while the levels of TG and LDL-C were increased. The TG level was correlated with the age, whether CAL was complicated or not, and the severity of CAL in KD children.
Key words: Kawasaki disease; blood lipids; coronary artery lesion; child
[1] | Kobayashi T, Ayusawa M, Suzuki H, et al. Revision of diagnostic guidelines for Kawasaki disease (6th revised edition)[J]. Pediatr Int, 2020, 62(10): 1135-1138. |
[2] | 中华医学会儿科学分会心血管学组, 中华儿科杂志编辑委员会. 川崎病冠状动脉病变的临床处理建议(2020年修订版)[J]. 中华儿科杂志, 2020, 58(9): 718-724. |
[3] | 何学华, 朱潜力, 袁勇华, 等. 川崎病合并冠状动脉瘤患儿应用华法林治疗的安全性[J]. 中华儿科杂志, 2021, 59(2): 95-100. |
[4] | Newburger JW, Burns JC, Beiser AS, et al. Altered lipid profile after Kawasaki syndrome[J]. Circulation, 1991, 84(2): 625-631. |
[5] | Yoshioka T, Matsutani T, Iwagami S, et al. Polyclonal expansion of TCRBV2- and TCRBV6-bearing T cells in patients with Kawasaki disease[J]. Immunology, 1999, 96(3): 465-472. |
[6] | Hourigan ST, Solly EL, Nankivell VA, et al. The regulation of miRNAs by reconstituted high-density lipoproteins in diabetes-impaired angiogenesis[J]. Sci Rep, 2018, 8(1): 13596. |
[7] | Yeom JS, Woo HO, Park JS, et al. Kawasaki disease in infants[J]. Korean J Pediatr, 2013, 56(9): 377-382. |
[8] | Fernandez-Cooke E, Barrios Tascón A, Sánchez-Manubens J, et al. Epidemiological and clinical features of Kawasaki disease in Spain over 5 years and risk factors for aneurysm development. (2011-2016): KAWA-RACE study group[J]. PLoS One, 2019, 14(5): e0215665. |
[9] | 王复娟, 吴良霞. 川崎病冠状动脉损害相关危险因素分析[J]. 临床儿科杂志, 2020, 38(7): 481-484. |
[10] | Peng Y, Liu X, Duan Z, et al. Age-related differences in clinical characteristics of Kawasaki disease[J]. Braz J Med Biol Res, 2021, 54(3): e10281. |
[11] | Shao S, Zhou K, Liu X, et al. Predictive value of serum lipid for intravenous immunoglobulin resistance and coronary artery lesion in Kawasaki disease[J]. J Clin Endocrinol Metab, 2021, 106(10): e4210-e4220. |
[12] | 廖先华, 许玉霞, 刘增荣. 川崎病患儿血脂代谢与冠状动脉病变的关系[J]. 华西医学, 2010, 25(6): 1036-1038. |
/
〈 |
|
〉 |